Breastfeeding duration is associated with higher adiposity at 6-8 months of age
Thanida Ua-Areechit1, Orapa Suteerojntrakool2,3, Tippawan Pongcharoen4
1Division of Nutrition, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Insights
Longer breastfeeding duration in Thai infants was linked to higher adiposity measures. However, this association may be influenced by reverse causality, suggesting further longitudinal research is needed.
Area of Science:
- Pediatrics
- Nutrition Science
- Public Health
Background:
- Breastfeeding (BF) is recognized for its protective role against childhood obesity.
- Existing evidence on the link between BF duration and infant adiposity is inconsistent.
- Limited research in Southeast Asian infants utilizes gold-standard methods for body composition assessment.
Purpose of the Study:
- To investigate the association between breastfeeding duration and body composition in Thai infants.
- To assess the relationship between BF duration and adiposity indicators during infancy.
Main Methods:
- Recruited 60 healthy, full-term Thai infants aged 6-8 months with at least 3 months of exclusive or predominant BF.
- Measured skinfold thickness (SFT) by trained personnel.
- Assessed body composition using the deuterium dilution technique, a gold-standard method.
Main Results:
- Infants breastfed longer (>6 months) exhibited higher subscapular SFT z-scores compared to those breastfed for shorter durations (≤6 months).
- Adjusted analyses revealed positive associations between BF duration, age of complementary feeding (CF) introduction, and fat mass index.
- The association weakened after adjusting for infant body mass index (BMI), suggesting potential reverse causality.
Conclusions:
- Longer breastfeeding duration and later introduction of complementary feeding were associated with increased fat mass index in infancy.
- The observed association might be influenced by reverse causality, where infants with lower BMI receive formula or CF earlier.
- Longitudinal studies are essential to confirm the impact of breastfeeding on adiposity throughout infancy and childhood.
Abstract:
Breastfeeding (BF) has been identified as a protective factor against childhood obesity. However, evidence of the association between BF duration and adiposity remains inconclusive. Few studies have been conducted among Southeast Asian infants that have measured body composition during infancy using the gold standard stable isotope method. This study aimed to evaluate the association between BF duration and body composition during infancy. Healthy full-term Thai infants aged 6-8 months (n = 60) receiving exclusive or predominant BF for at least 3 months were recruited. Skinfold thickness (SFT) was measured by well-trained investigators. Body composition was assessed by the deuterium dilution technique. Infants with longer BF duration (>6 months; mean 7.5 ± 0.5 months, n = 29) had a higher subscapular SFT z-score than those with shorter BF duration (≤6 months; mean 5.3± 0.9 months, n = 31) by 0.48 (95% confidence interval [CI]: 0.01-0.94). After adjustment for age and sex, BF duration and age at introduction of complementary feeding (CF) were positively associated with fat mass and fat mass index at 6-8 months. One month increase in BF duration and CF age was associated with a 0.37 (95% CI: 0.05, 0.69) kg/m2 and 0.76 (95% CI: 0.18, 1.34) kg/m2 increase in the fat mass index, respectively. After adjusting for infant body mass index (BMI) during the earlier infancy period, the strength of the association was attenuated. This finding may reflect reverse causality where infants with lower BMI received formula or CF earlier. A longitudinal study with follow-up into childhood is warranted to confirm the effects of BF on adiposity in infancy and childhood.
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